Association of Fatigue with Perceived Stress in Chinese Women with Early Stage Breast Cancer Awaiting Adjuvant Radiotherapy

Stress Health. 2015 Aug;31(3):214-21. doi: 10.1002/smi.2548. Epub 2013 Oct 29.

Abstract

Cancer-related fatigue (CRF) is common in women with breast cancer, but little is known of its relationship with perceived stress. We conducted a cross-sectional study to explore the associations of CRF with perceived stress, anxiety, depression, pain and sleep quality in 133 Chinese women (aged 25-68 years) with early stage breast cancer. The majority of women had completed surgery and chemotherapy and were awaiting radiotherapy. Self-administered questionnaires consisting of the Brief Fatigue Inventory, Perceived Stress Scale-10, Hospital Anxiety and Depression Scale, Brief Pain Inventory, and Pittsburgh Sleep Quality Index were used to collect data. Forty-five per cent of the women were severely fatigued. Compared with local healthy women and US breast cancer patients, the group's mean perceived stress score was significantly higher (both p < 0.01). Higher perceived stress (β = 0.18, p = 0.032), higher anxiety (β = 0.30, p < 0.001) and higher pain severity (β = 0.38, p < 0.001) were associated with increased severity of CRF. The association of CRF with perceived stress was partially mediated by anxiety, suggesting a possible pathway from cancer and cancer treatment to CRF via stress appraisals and emotional distress. The findings indicate the importance of monitoring the psychological status of patients during treatment.

Keywords: Chinese; anxiety; breast cancer; cancer‐related fatigue; perceived stress.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Asian People / psychology
  • Breast Neoplasms / psychology*
  • Breast Neoplasms / radiotherapy
  • Cross-Sectional Studies
  • Fatigue / psychology*
  • Female
  • Hong Kong / epidemiology
  • Humans
  • Middle Aged
  • Pain / psychology*
  • Radiotherapy, Adjuvant
  • Sleep / physiology*
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires